Perceptions of Heated Tobacco Products (HTPs) vs. Cigarettes and E-Cigarettes in Relation to Likelihood of Trying HTPs or Suggesting HTPs to Those Who Smoke Cigarettes

Authors

Zongshuan Duan, Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Yael Bar-Zeev, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel.
Lorien C. Abroms, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Amal Khayat, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel.
Yuxian Cui, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Cassidy R. LoParco, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Hagai Levine, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel.

Document Type

Journal Article

Publication Date

4-26-2024

Journal

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

DOI

10.1093/ntr/ntae093

Keywords

IQOS; cigarettes; e-cigarettes; heated tobacco product; relative perceptions; tobacco

Abstract

INTRODUCTION: Heated tobacco products (HTPs), like IQOS, are marketed as innovative, stylish, harm-reduction products distinct from cigarettes and e-cigarettes. Research is needed to better understand how adults who are newly introduced to HTPs perceive them relative to cigarettes and e-cigarettes, and the impact of these perceptions on use outcomes. METHODS: We analyzed 2021 cross-sectional survey data from 1,914 adults who never used HTPs from the United States and Israel, two countries where IQOS has unique histories and markets. Exploratory factor analysis examined perceptions of HTPs (vs. cigarettes and e-cigarettes) across 12 perception measures (e.g., innovative, trendy, harmful, addictive). Multivariable linear regression examined these factors in relation to self-reported likelihood to: 1) "try HTPs in the next year" (1=not-7=extremely); and 2) "suggest IQOS to a friend who smokes cigarettes" (1=not-5=very), controlling for demographics and past-month cigarette and e-cigarette use (10.1% dual use, 15.4% cigarette-only, 5.7% e-cigarette-only, 68.8% neither). RESULTS: Four factors were identified: HTPs' health and utility ('health-utility') and design and appeal ('design-appeal') vs. cigarettes and vs. e-cigarettes, separately. More favorable perceptions of HTP vs. e-cigarette design-appeal (B=0.30, 95%CI=0.18, 0.41) was associated with greater likelihood to try HTPs. More favorable perceptions of HTP vs. cigarette design-appeal (B=0.38, 95%CI=0.26, 0.51) and health-utility (B=0.25, 95%CI=0.13, 0.36), and HTP vs. e-cigarette design-appeal (B=0.32, 95%CI=0.20, 0.45) were associated with greater likelihood to suggest HTPs to smokers. CONCLUSIONS: Monitoring perceptions of HTPs vs. cigarettes and e-cigarettes is critical given the role of such perceptions in HTP use and their population-level impact. IMPLICATIONS: This study examined the relationship of perceptions of HTPs relative to cigarettes and e-cigarettes, with regard to adults' self-reported likelihood to use HTP or to suggest HTPs to those who smoke cigarettes. Favorable perceptions of HTPs' design and appeal versus e-cigarettes correlated with greater likelihood to try HTPs. Favorable perceptions of HTPs' design and appeal, as well as health and utility, versus cigarettes and e-cigarettes correlated with greater likelihood to suggest HTPs to those who smoke. Findings underscore the need for ongoing surveillance of HTP marketing and consumer perceptions to inform regulatory efforts and estimate the population-level impact of HTPs and other tobacco products.

APA Citation

Duan, Zongshuan; Berg, Carla J.; Bar-Zeev, Yael; Abroms, Lorien C.; Wang, Yan; Khayat, Amal; Cui, Yuxian; LoParco, Cassidy R.; and Levine, Hagai, "Perceptions of Heated Tobacco Products (HTPs) vs. Cigarettes and E-Cigarettes in Relation to Likelihood of Trying HTPs or Suggesting HTPs to Those Who Smoke Cigarettes" (2024). GW Authored Works. Paper 4671.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4671

Department

Prevention and Community Health